Healthcare Provider Details

I. General information

NPI: 1063919538
Provider Name (Legal Business Name): RONALD LEE JONES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 04/27/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 DUNN RD DEPT NEUROLOGY, STE 110
SAINT LOUIS MO
63136-6132
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-953-8340
  • Fax: 314-953-8341
Mailing address:
  • Phone: 314-953-8340
  • Fax: 314-953-8341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2022031681
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: